Individual
BRENNAN BONATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7373 W JEFFERSON AVE, LAKEWOOD, CO 80235
(303) 988-7800
Mailing address
11883 W 27TH DR, LAKEWOOD, CO 80215-7000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00202895
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00202895
DENTAL LICENSE
CO
Enumeration date
10/20/2016
Last updated
06/20/2018
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